In the upside-down world of ObamaCare, politicians can force health-insurance companies to spend more yet blame them when premiums increase.

Today, President Obama extolled new “protections” included in the sweeping legislation he signed into law on March 23.

One category of “protections” requires consumers to purchase coverage for more and more expensive medical services (e.g., limitless coverage, requiring insurers to recognize ob-gyns as primary care physicians, coverage for “children” up to age 26).  If consumers valued such “protections,” they would have already bought them — and if they’re not in a position to select their own coverage, Congress should have fixed that problem.  Instead, Congress and President Obama forced consumers to buy them, and they are pushing health insurance premiums higher.

Another category of “protections” are actually just price controls.  Beginning this fall, ObamaCare will force insurers to cover minors with expensive conditions and at the same time charge those families far less than the costs they impose on the insurer.  Beginning in 2014, similar price controls will govern the entire market.  Insurers will respond by avoiding, mistreating, and dumping sick people, because that’s what these price controls reward.  Harvard health economist David Cutler, a sometime-advisor to President Obama, finds that health plans that provide quality care to the sick go out of business in the presence of those price controls.  If you think insurers mistreat the sick now, just wait until ObamaCare takes hold.  Along the way, ObamaCare’s price controls will increase premiums for young and healthy Americans.

Rather than take responsibility for its own law, the Obama administration is scapegoating insurance companies.  According to The New York Times, “The White House is concerned that health insurers will blame the new law for increases in premiums that are intended to maximize profits rather than covering claims.”  We’ve seen this before.  Massachusetts enacted a nearly identical law, which also caused premiums to rise.  State officials responded by imposing premium caps (more price controls!), which will force insurers to ration care.  As Massachusetts’ Deputy Commission for Financial Analysis at the Massachusetts Division of Insurance put it, premium caps will be a “train wreck.”

Meanwhile, “The administration worries that escalating premiums will force more people drop their policies before the law is fully implemented,” writes the Associated Press.  The administration is right to worry.  ObamaCare is already increasing premiums, and in 2014, it will force insurers to cover you at standard rates even if you get sick, which creates an even bigger incentive to drop coverage.

Hmm…there’s gotta be someone the administration can blame for that, too.

Obama to Health Insurers: Stop Revealing How Expensive Our “Protections” Are is a post from Cato @ Liberty - Cato Institute Blog

John Lee still has his life and four children still have a father because Mr. Lee  had a handgun when three criminals tried to kill him and take his money.

When John Q. Citizen takes out a gun and the criminals flee, reporters don’t consider the incident “news” (at least when there are no injuries)–so guns are typically on the evening news when they are used by criminals.  As a result of that skewed coverage, it is no wonder that many people have a negative view about firearms.

On June 17, Cato will be hosting a forum about guns, crime, and self-defense.  Speakers include John Lott, Jeff Snyder, and Paul Helmke of the Brady Campaign.

For related Cato scholarship, go here.

Guns Save Lives, Part XXXIVXX is a post from Cato @ Liberty - Cato Institute Blog

Earlier today, I attended a lecture at CSIS by John Brennan, a leading counterterrorism and homeland security adviser to President Obama. His speech highlighted some of the key elements of the administration’s counterterrorism strategy, in advance of tomorrow’s release of the National Security Strategy (NSS).

I hope that many people will take the opportunity to read (.pdf) or listen to/watch Brennan’s speech, as opposed to merely reading what other people said that he said. Echoing key themes that Brennan put forward last year, also at CSIS, today’s talk reflected a level of sophistication that is required when addressing the difficult but eminently manageable problem of terrorism.

Brennan was most eloquent in talking about the nature of the struggle. He declared, with emphasis, that the United States is indeed at war with al Qaeda and its affiliates, but not at war with the tactic of terrorism, nor with Islam, a misconception that is widely held both here in the United States and within the Muslim world. He stressed the positive role that Muslim clerics and other leaders within the Muslim community have played in criticizing the misuse of religion to advance a hateful ideology, and he lamented that such condemnations of bin Laden and others have not received enough exposure in the Western media. This inadequate coverage of the debate raging within the Muslim community contributes to the mistaken impression that this is chiefly a religious conflict. It isn’t; or, more accurately, it need not be, unless we make it so.

I also welcomed Brennan’s unabashed defense of a counterterrorism strategy that placed American values at the forefront. These values include a respect for the rule of law, transparency, individual liberty, tolerance, and diversity. And he candidly stated what any responsible policymaker must: no nation can possibly prevent every single attack. In those tragic instances where a determined person slips through the cracks, the goal must be to recover quickly, and to demonstrate a level of resilience that undermines the appeal of terrorism as a tactic in the future.

I had an opportunity to ask Brennan a question about the role of communication in the administration’s counterterrorism strategy. He assured me that there was such a communications strategy, that elements of the strategy would come through in the NSS, and that such elements have informed how the administration has addressed the problem of terrorism from the outset.

This was comforting to hear, and it is consistent with what I’ve observed over the past 16 months. Members of the Obama administration, from the president on down, seem to understand that how you talk about terrorism is as important as how you disrupt terrorist plots, kill or capture terrorist leaders, and otherwise enhance the nation’s physical security. On numerous occasions, the president has stressed that the United States cannot be brought down by a band of murderous thugs. Brennan reiterated that point today. This should be obvious, and yet such comments stand in stark contrast to the apolocalytpic warnings from a few years ago of an evil Islamic caliphate sweeping across the globe.

Talking about terrorism might seem an esoteric point. It isn’t. Indeed, it is a key theme in our just released book, Terrorizing Ourselves: Why U.S. Counterterrorism Policy Is Failing and How to Fix It. Because the object of terrorism is to terrorize, to elicit from a targeted state or people a response, and to (in the terrorists’s wildest dreams) cause the state to waste blood and treasure, or come loose from its ideological moorings, a comprehensive counterterrorism strategy should aim at building a psychologically resilient society. Such a society should possess an accurate understanding of the nature of the threat, a clear sense of what policies or measures are useful in mitigating that threat, and an awareness of how overreaction does the terrorists’s work for them. The true measure of a resilient society, one that isn’t in thrall to the specter of terrorism, is the degree to which it can conduct an adult conversation about the topic.

We aren’t there yet, but I’m encouraged by what I’ve seen so far, and by what I heard today.

John Brennan on Countering Terrorism is a post from Cato @ Liberty - Cato Institute Blog

The Associated Press reports:

Buyers, beware: President Barack Obama says his health care overhaul will lower premiums by double digits, but check the fine print…

The [Congressional Budget Office] concluded that premiums for people buying their own coverage would go up by an average of 10 percent to 13 percent, compared with the levels they’d reach without the legislation…

“People are likely to not buy the same low-value policies they are buying now,” said health economist Len Nichols of George Mason University. “If they did buy the same value plans … the premium would be lower than it is now. This makes the White House statement true. But is it possibly misleading for some people? Sure.”

Nichols’ comments are also misleading — which makes the president’s statement not just misleading but untrue.

Under ObamaCare, people would not have the option to buy the same low-cost plans they do today.  That’s the whole problem: under an individual mandate, everybody must purchase the minimum level of coverage specified by the government.  That minimum benefits package would be more expensive than the coverage chosen by most people in the individual market.  Their premiums would rise because ObamaCare would take away their right to choose a more economical policy.

Note also that the CBO predicts premiums would rise by an average of 10-13 percent in the individual market.  Consumers who currently purchase the most economic policies would see larger premium increases.

Finally, the Obama plan would also force millions of uninsured Americans to purchase health insurance at premiums higher than current-law premium levels, which they have already rejected as being too high.  Their premium expenditures would rise from $0 to thousands of dollars.  Yet the CBO counts that implicit tax as reducing average premiums, because those consumers are generally healthier-than-average.  Only in Washington is a tax counted as a savings.

AP: Obama Misleads Voters about ObamaCare’s Effects on Premiums is a post from Cato @ Liberty - Cato Institute Blog

Noting that premium increases, such as Anthem’s proposed 39-percent hike in California, have caused individuals and employers to purchase less coverage, Kaiser Family Foundation president Drew Altman writes:

Rising health care costs and insurance company practices are leading not just to more expensive premiums, but to skimpier, less comprehensive coverage as well; slowly redefining what we have known as health insurance. To be sure, some economists argue that this is precisely what should happen…But this is not likely how regular people see it. Appropriate cost sharing is one thing, but we may be reaching the point in the individual market where the policies many people have simply cannot be considered meaningful coverage.

Of course, this is the whole idea behind President Obama’s proposed tax on high-cost health plans: higher prices will cause people to purchase less coverage, which will temper health care spending.

But whether Altman is correct depends on what the meaning of “meaningful” is.  When individuals pare back the amount of insurance they purchase, they are revealing what they consider to be meaningful coverage.  (The same is true when employers opt for less-comprehensive coverage, though employers’ revealed preferences are obviously a poor proxy for what their workers value.)

If Altman thinks the coverage that individuals are choosing “cannot be considered meaningful coverage” (note the passive voice), he is implicitly stating that individuals are not the best judges of their own welfare.  And the only way to devise an alternative definition of meaningful coverage is through the political process.

It is difficult to argue that the political process does a better job of selecting meaningful coverage.  That process forces many consumers to purchase coverage that they don’t find meaningful (e.g., chiropractic, acupuncture, circumcision), that they find offensive (e.g., abortion, contraception, in-vitro fertilization), or for treatments that are downright harmful (e.g., high-dose chemotherapy combined with autologous bone-marrow transplant for late-stage breast cancer).

Letting consumers reveal their preferences is possibly the worst way to define “meaningful coverage.”  Except for all the others.

What Is ‘Meaningful’ Health Insurance? Who Decides?’ is a post from Cato @ Liberty - Cato Institute Blog

Even if Democrat Martha Coakley wins 50 percent of the vote in the race to fill the late Sen. Ted Kennedy’s (ahem) term, there are other numbers emanating from Massachusetts that present a problem for President Obama’s health plan.

On Wednesday, the Cato Institute will release “The Massachusetts Health Plan: Much Pain, Little Gain,” authored by Cato adjunct scholar Aaron Yelowitz and yours truly. Our study evaluates Massachusetts’ 2006 health law, which bears a “remarkable resemblance” to the president’s plan. We use the same methodology as previous work by the Urban Institute, but ours is the first study to evaluate the effects of the Massachusetts law using Current Population Survey data for 2008 (i.e., from the 2009 March supplement).  Since I’m sure that supporters of the Massachusetts law and the Obama plan will dismiss anything from Cato as ideologically motivated hackery: Yelowitz’s empirical work is frequently cited by the Congressional Budget Office, and includes one article co-authored with MIT health economist (and Obama administration consultant) Jonathan Gruber, under whom Yelowitz studied.

Among our findings:

• Official estimates overstate the coverage gains under the Massachusetts law by roughly 50 percent.
• The actual coverage gains may be lower still, because uninsured Massachusetts residents appear to be concealing their lack of insurance rather than admit to breaking the law.
• Public programs crowded out private insurance among low-income children and adults.
• Self-reported health improved for some, but fell for others.
• Young adults appear to be avoiding Massachusetts as a result of the law.
• Leading estimates understate the cost of the Massachusetts law by at least one third.

When Obama campaigns for Martha Coakley, he is really campaigning for his health plan, which means he is really campaigning for the Massachusetts health plan.

He and Coakley should explain why they’re pursuing a health plan that’s not only increasingly unpopular, but also appears to have a rather high cost-benefit ratio.

(Cross-posted at Politico‘s Health Care Arena.)

Obama’s Other Massachusetts Problem is a post from Cato @ Liberty - Cato Institute Blog

In a new study titled, “Obama’s Prescription for Low-Wage Workers: High Implicit Taxes, Higher Premiums,” I show that the House and Senate health care bills would impose implicit tax rates on low-wage workers that exceed 100 percent.  Here’s the executive summary:

House and Senate Democrats have produced health care legislation whose mandates, subsidies, tax penalties, and health insurance regulations would penalize work and reward Americans who refuse to purchase health insurance. As a result, the legislation could trap many Americans in low-wage jobs and cause even higher health-insurance premiums, government spending, and taxes than are envisioned in the legislation.

Those mandates and subsidies would impose effective marginal tax rates on low-wage workers that would average between 53 and 74 percent— and even reach as high as 82 percent—over broad ranges of earned income. By comparison, the wealthiest Americans would face tax rates no higher than 47.9 percent.

Over smaller ranges of earned income, the legislation would impose effective marginal tax rates that exceed 100 percent. Families of four would see effective marginal tax rates as high as 174 percent under the Senate bill and 159 percent under the House bill. Under the Senate bill, adults starting at $14,560 who earn an additional $560 would see their total income fall by $200 due to higher taxes and reduced subsidies. Under the House bill, families of four starting at $43,670 who earn an additional $1,100 would see their total income fall by $870.

In addition, middle-income workers could save as much as $8,000 per year by dropping coverage and purchasing health insurance only when sick. Indeed, the legislation effectively removes any penalty on such behavior by forcing insurers to sell health insurance to the uninsured at standard premiums when they fall ill. The legislation would thus encourage “adverse selection”—an unstable situation that would drive insurance premiums, government spending, and taxes even higher.

See also my Kaiser Health News oped, “Individual Mandate Would Impose High Implicit Taxes on Low-Wage Workers.”

And be sure to pre-register for our January 28 policy forum, “ObamaCare’s High Implicit Tax Rates for Low-Wage Workers,” where the Urban Institute’s Gene Steuerle and I will discuss these obnoxious implicit tax rates.

(Cross-posted at Politico‘s Health Care Arena.)

Dear Poor People: Please Remain Poor. Sincerely, ObamaCare is a post from Cato @ Liberty - Cato Institute Blog

Senate Majority Leader Harry Reid (D-NV) has announced that he has reached a super secret compromise on how to deal with the so-called public option for health reform.  While Reid said the agreement was too important to actually tell anyone what is in it, most of the details have been leaked to the press.

Rather than set-up a completely government-run insurance plan to compete with private insurance, Congress would establish a program similar to the Federal Employees Health Benefit Program (FEHBP), which currently covers government workers, including Members of Congress.  The FEHBP offers a variety of private insurance plans under a program managed by the US Office of Personnel Management (OPM).  Each year OPM uses the Federal procurement process to solicit bids from insurance companies to be one of the plans offered.  Premiums can vary, but participating plans operate under stringent rules.   As a model, the FEHBP is apparently acceptable to moderate Democrats because the insurance plans are private rather than government entities, while liberals like it because it is government regulated and managed.

In addition, the compromise plan would expand Medicare, allowing workers ages 55 to 65 to “buy in” to the program, and may also expand Medicaid.

A few reasons to believe this is yet another truly bad idea:

1. In choosing the FEHBP for a model, Democrats have actually chosen an insurance plan whose costs are rising faster than average.   FEHBP premiums are expected to rise 7.9 percent this year and 8.8 percent in 2010.  By comparison, the Congressional Budget Office predicts that on average, premiums will increase by 5.5 to 6.2 percent annually over the next few years.  In fact, FEHBP premiums are rising so fast that nearly 100,000 federal employees have opted out of the program.
2. FEHBP members are also finding their choices cut back.  Next year, 32 insurance plans will either drop out of the program or reduce their participation.  Some 61,000 workers will lose their current coverage.
3. But former OPM director Linda Springer doubts that the agency has the “capacity, the staff, or the mission,” to be able to manage the new program.  Taking on management of the new program could overburden OPM.  “Ultimate, it would break the system.”
4. Medicare is currently $50-100 trillion in debt, depending on which accounting measure you use.  Allowing younger workers to join the program is the equivalent of crowding a few more passengers onto the Titanic.
5. At the same time, Medicare under reimburses physicians, especially in rural areas.  Expanding Medicare enrollment will both threaten the continued viability of rural hospitals and other providers, and also result in increased cost-shifting, driving up premiums for private insurance.
6. Medicaid is equally a budget-buster. The program now costs more than $330 billion per year, a cost that grew at a rate of roughly 10.7 percent annually.  The program spends money by the bushel, yet under-reimburses providers even worse than Medicare.
7. Ultimately this so-called compromise would expand government health care programs and further squeeze private insurance, resulting in increased costs and higher insurance premiums, and provide a lower-quality of care.

No wonder Senator Reid wants to keep it a secret.

FEHBP Plan Is No ‘Moderate Compromise’ is a post from Cato @ Liberty - Cato Institute Blog

Great news – for a change!  A Mississippi court has ordered a new trial for Cory Maye.

When Cato author Radley Balko was preparing his report on violent, no-knock, drug raids, he discovered the case of Cory Maye, who was then on death row for murdering a police officer.  On closer inspection, Radley thought the shooting looked like self-defense, not murder.  At Maye’s initial trial, he had lousy legal representation.  Thanks to Radley’s writings about the case, Maye secured top notch lawyers for his appeal.  With a new trial, Maye now stands a very good chance of getting out of prison altogether.  Congratulations to Radley Balko!

Previous coverage here.

New Trial For Cory Maye is a post from Cato @ Liberty - Cato Institute Blog

The New Republic‘s Jonathan Cohn reports that back in March, IMS Health projected slightly negative revenue growth for the pharmaceutical industry but recently changed that projection to 3.5-percent annual growth from 2008 through 2013.

“What changed?” Cohn asks. “A major factor, according to IMS, was the emerging details of health care reform . . . Put it all together, and you have more demand for name-brand drugs . . . enough to boost revenue significantly.” And:

“If this bill is implemented,” the report concludes on page 138, “an increase in prices on new drugs can be expected.”

How could this be happening?  Oh yeah:

That brings us back to the deal that the Pharmaceutical Researchers and Manufacturers of America, which represents those companies, made with the White House and Senate Finance Committee . . .

The industry agreed to embrace health care reform and, later on, launched a massive advertising campaign to promote the cause. In exchange, the White House and Senate Finance–which had been asking various industries to pledge concessions that would help pay for the cost of coverage expansions–promised not to seek more than $80 in reduced payments to drug makers.

To an industry as big and profitable as the drug makers, giving up $80 billion over ten years wouldn’t seem like much of a sacrifice–a point critics started making right away. But if IMS is right, the drug industry wouldn’t even be giving up $80 billion, in any meaningful sense of the term. If anything, it’d be making more money. Maybe quite a lot of it.

Which is what I predicted, both here and here.

Cohn concludes, “the drug industry has enormous leverage in Congress.” But Cohn still supports the president’s health care takeover. Or is it PhRMA’s health care takeover?

ObamaCare’s ‘Sweetheart Deal’ for PhRMA is a post from Cato @ Liberty - Cato Institute Blog

President Obama’s approach to health care reform — forcing taxpayers to subsidize health insurance for tens of millions of Americans — cannot not change the status quo on abortion.

Either those taxpayer dollars will fund abortions, or the restrictions necessary to prevent taxpayer funding will curtail access to private abortion coverage. There is no middle ground.

Thus both sides’ fears are justified. Both sides of the abortion debate are learning why government should not subsidize health care. Tip of the hat to President Obama for creating this teachable moment.

Meanwhile, Catholics should be outraged at the United States Conference of Catholic Bishops (to which my grandfather served as counsel). Yes, the USCCB helped prevent taxpayer funding of abortions in the House bill. But at the same time, those naughty bishops have abandoned the Church’s doctrine of subsidiarity by endorsing the rest of the Democrats’ plan to centralize power in Washington.

As it happens, Caesar is the main source of funding for Catholic hospitals. That may explain why the bishops are so eager to render unto, ahem, Him.

Cross-posted at Politico’s Health Care Arena.

Abortion Funding and Health Care is a post from Cato @ Liberty - Cato Institute Blog

Democrats are having difficulty corralling 218 votes for the Pelosi bill because Americans do not want government to be as big and as powerful as the House leadership does. Pro-life Democrats do not want a government so big that it can force taxpayers to fund abortions. Pro-choice Democrats do not want a government so big that it uses subsidies to restrict access to abortion coverage. Other Democrats don’t want a government so big that it turns the United States into a welfare magnet.

The American people don’t want the Democrats’ approach to health care generally. The more time the public has to digest ObamaCare, the more they dislike it:

And the Pelosi bill is the most expensive and extreme version of ObamaCare.  Opposition will climb higher when the public learns the bill costs some $1.5 trillion more than Democrats claim.

Even a majority vote would not necessarily indicate majority support for the Pelosi bill. Rep. Jim Cooper (TN) and other Democrats are voting aye only because they want to keep the process moving – i.e., because this isn’t the vote that counts.

Win or lose, tonight’s vote will be the high water mark for the Pelosi bill.

(Cross-posted at Politico‘s Health Care Arena.)

The Pelosi Bill’s High Water Mark is a post from Cato @ Liberty - Cato Institute Blog

At his White House forum on health reform back in March, President Barack Obama offered:

If there is a way of getting this done where we’re driving down costs and people are getting health insurance at an affordable rate, and have choice of doctor, have flexibility in terms of their plans, and we could do that entirely through the market, I’d be happy to do it that way.

In a new Cato study titled, “Yes, Mr. President, a Free Market Can Fix Health Care,” I take up the president’s challenge and explain that markets are indeed the only way to achieve those goals.  I also explain how Congress can remove the impediments that currently prevent markets from doing so:

1. Give Medicare enrollees a voucher (adjusted for their means and health risk) and let them purchase any health plan on the market,
2. Reform the tax treatment of health care with “large” health savings accounts, which would give workers a $9.7 trillion tax cut (without increasing the deficit) and free them to purchase secure coverage that meets their needs,
3. Free consumers and employers to purchase health insurance across state lines (i.e., licensed by other states), which could cover up to one third of the uninsured,
4. Make state-issued clinician licenses portable, which would increase access to care and competition among health plans, and
5. Block-grant Medicaid and the State Children’s Health Insurance Program, just as Congress did with welfare.

Unlike the president’s health care proposals (which, as Victor Fuchs explains, would merely shift costs), these reforms would reduce costs, expand coverage, and improve health care quality – without new taxes, government subsidies, or deficit spending.

Would a free market be nirvana?  Of course not.  But fewer Americans would fall through the cracks than under the status quo or the government takeover advancing through Congress.

There is a better way.

(Cross-posted at Politico‘s Health Care Arena.)

Yes, Mr. President, a Free Market Can Fix Health Care is a post from Cato @ Liberty - Cato Institute Blog

If the goal is to improve health, then the answer is clearly no.

Ironically, even though universal coverage is presumably about helping the sick, the Democrats’ pursuit of universal coverage demonstrates not how much, but how little they care about their neighbors’ health.

Economists Helen Levy and David Meltzer explain, in a book published by the Urban Institute, “There is no evidence at this time that money aimed at improving health would be better spent on expanding insurance coverage than on…other possibilities,” such as clinics, hypertension screening, nutrition campaigns, or even education.  In the Annual Review of Public Health, they explain further:

The central question of how health insurance affects health, for whom it matters, and how much, remains largely unanswered at the level of detail needed to inform policy decisions…Understanding the magnitude of health benefits associated with insurance is not just an academic exercise…it is crucial to ensuring that the benefits of a given amount of public spending on health are maximized.

If Democrats were serious about improving health, they would first gather evidence about which of those strategies produces the most health per dollar spent.  (As I recommend elsewhere, the $1.1 billion Congress allocated for comparative-effectiveness research should just about do the trick.)  Democrats would then fund the most cost-effective strategies, which may or may not include broader insurance coverage.

But the fact that Democrats are pursuing universal coverage without any such evidence necessarily means that they are willing to sacrifice potentially greater health improvements to achieve…whatever else they hope universal coverage will achieve.

Universal coverage is not about improving public health.  It is about subordinating health to some X-factor that supporters value even more.

Which leads to an even more intriguing question: what is that X-factor?

Financial security?  (If so, would universal coverage achieve that?  Or are there better strategies?)  Political power?  Dependence on government?  Industry subsidies?  The appearance of compassion?

I’d like to see that question put to the group.

(Cross-posted at National Journal’s Health Care Experts Blog.)

Should Congress Even Try to Achieve Universal Coverage? is a post from Cato @ Liberty - Cato Institute Blog

Yes, you read that right.  And I had to do the same sort of double-take when I read David Broder’s op-ed in The Washington Post this morning.

Broder writes, “Obama has steered the enterprise to the point that odds now favor a bill-signing ceremony.  But the hardest choices still lie ahead….”  Whaa??  How can the odds be better than 50-50 if the biggest fights haven’t even happened yet?

Broder’s optimism continues, “Two things will be needed to reach [a majority in the House and 60 votes in the Senate]: first, a plausible plan for making affordable and comprehensive health insurance available to millions…. And second, a way of financing the coverage….”  But that’s been the whole challenge all along.  Is Broder actually acknowledging that Democrats aren’t any closer to a signing ceremony than they were six months ago?

Broder says Democrats can meet the second challenge by taxing high-cost health plans — “a step that would require Obama to face down his labor union allies.”  You mean Obama should lean on Democrats to tax a crucial part of their own base?  One that’s already activating to block that tax?

Broder also thinks Obama should lean on his fellow Democrats to roll the doctors and hospitals in their states/districts by including more (some? any?) “delivery system reforms” in the legislation.

Sure.  No problem.  What could go wrong?  This is practically a done deal.

(Cross-posted, sarcasm and all, at Politico‘s Health Care Arena.)

Broder: Health Overhaul Likely, Because Hardest Part Lies Ahead is a post from Cato @ Liberty - Cato Institute Blog

In my recent Cato paper, “All the President’s Mandates: Compulsory Health Insurance Is a Government Takeover,” I explain that if Congress compels Americans to purchase health insurance, it would “inevitably and unnecessarily open a new front in the abortion debate, one where either side—and possibly both sides—could lose.”

Slate‘s William Saletan explains how the pro-choice side could lose:

This week, the Senate finance committee is considering amendments that would bar coverage of abortions under federally subsidized health insurance. Pro-choice groups are up in arms. After all, says NARAL Pro-Choice America, “In the current insurance marketplace, private plans can choose whether to cover abortion care—and most do.” If Congress enacts subsidies that exclude abortion, “women could lose coverage for abortion care, even if their private health-insurance plan already covers it!“…

The argument these groups make is perfectly logical: If you standardize health insurance through federal subsidies and coverage requirements, people might lose benefits they used to enjoy in the private sector. But that’s more than an argument against excluding abortion. It’s an argument against health care reform altogether.

Saletan also explains why pro-life and pro-choice positions on Obama’s health plan are irreconcilable:

To get what they consider neutrality, pro-choicers have to make pro-lifers pay indirectly for abortions. And to keep what they consider clean hands, pro-lifers have to make abortion coverage federally unsupportable and therefore, in a subsidy-dependent system, commercially nonviable.

Rather than an argument against all health care reform, I’d say this is an argument against reforms that expand government subsidies or otherwise give government the power to choose what kind of insurance you purchase.  Fortunately, there are better ways to reform health care.

“Keep Your Subsidies off My Ovaries” is a post from Cato @ Liberty - Cato Institute Blog

• Should more troops be sent to Afghanistan? Cato’s Malou Innocent weighs in alongside the policymakers.

• What does the end of the missile defense system in Central Europe means for U.S.-Russian relations?

• Signals indicate that the market just might be on the rebound. That’s great,  but it’s important not to get ahead of ourselves, says Johan Norberg.  “We must never forget that the light at the end of the tunnel can be an approaching train.”

• A few thoughts on the new rise of the Taliban in Afghanistan, and what it means for Pakistan and India.

• Michael Cannon continues his debate in the LA Times: The dirty little secret is that “Obama-care” isn’t about reducing health care costs or making coverage more secure. It’s about robbing Peter to pay Paul.

• Podcast: If you’d like to see what Obama wants to do to the U.S. health care system, don’t listen to his rhetoric…look at what he’s doing to Medicare.

Wednesday Links is a post from Cato @ Liberty - Cato Institute Blog

President Obama argued on TV talk shows this weekend that his proposed mandate for everyone to buy health insurance – or face a large financial penalty – is not a tax increase:

In a testy exchange on ABC’s “This Week,” broadcast Sunday, Obama rejected the assertion that forcing people to obtain coverage would violate his campaign pledge against raising taxes on middle-class Americans.

“For us to say you have to take responsibility to get health insurance is absolutely not a tax increase,” Obama said in response to persistent questioning, later adding: “Nobody considers that a tax increase.”

Well, I consider it a tax increase, so I guess that makes me nobody.

The real question is whether this tax increase is a good idea. My answer is no. If others disagree, then fine, let’s have that debate. But denying plain truths suggests that advocates of Obamacare are trying to pass something that Americans would not endorse if it were structured and explained clearly.

Watch:

Obama: ‘Nobody’ Considers Health Care Mandate a Tax Increase is a post from Cato @ Liberty - Cato Institute Blog

In their attempt to defeat Obamacare, Republicans have focused their criticism on the public option, painting it as the most objectionable feature of existing proposals. Senator Max Baucus, (D-Mont.), has now proposed a plan without the public option. This leaves the Republicans in an awkward position, especially since Baucus’s plan is projected to cost less than earlier proposals.

If Republicans oppose the Baucus plan, they surely risk the ire of voters who will be told during the mid-term elections, “The Republicans blocked a plan that would have covered the uninsured and reduced the deficit.”

The problem is, the public option was never the crucial issue; instead, it was the mandate to purchase insurance. Once government mandates insurance coverage, it gets to define what constitutes insurance, which means it can ban pre-existing condition clauses and the like. The mandate also”justifies” large subsidies for insurance, to avoid non-compliance with the mandate. So, an individual mandate, which the Baucus plan includes, implies a rapid takeover of the entire health care system by the federal government.

Something like the Baucus plan will pass. It will either cost far more than existing projections, if government administrators fail to impose the restrictions on reimbursements that generate the projected cost savings, or it will involve massive rationing of care.

The Democrats played it perfectly. The Republicans got sucker-punched.

C/P Libertarianism, from A to Z

Have the Democrats Outsmarted the Republicans on Health Care? is a post from Cato @ Liberty - Cato Institute Blog

A front-page Washington Post story today notes that the cost of Obama-style health care reform will fall disproportionately on young adults.

Younger workers are typically more healthy than the population at large, and a significant share of them quite rationally choose not to buy health insurance, as my colleague Mike Tanner explains in a recent op-ed. The major health care plans on the table in Washington would force them to buy coverage. As the Post story explains:

Drafting young adults into any health-care reform package is crucial to paying for it. As low-cost additions to insurance pools, young adults would help dilute the expense of covering older, sicker people. Depending on how Congress requires insurers to price their policies, this group could even wind up paying disproportionately hefty premiums—effectively subsidizing coverage for their parents.

I’m beginning to see a pattern. Those same young workers will be forced to pay the bills for soaring Social Security and Medicare expenditures when the Baby Boomers begin retiring en masse a decade from now. And of course, they will be the ones paying off the $9 trillion in additional federal debt expected to be wracked up from the current explosion in federal spending.

I always thought parents were supposed to support their kids, not saddle them with bigger bills and huge debts.

20-somethings Will Pay for Big Government is a post from Cato @ Liberty - Cato Institute Blog